Healthcare Provider Details

I. General information

NPI: 1447403944
Provider Name (Legal Business Name): SAMIYYAH KABARA NEW APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/28/2008
Last Update Date: 05/09/2026
Certification Date: 05/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15405 STONE MEADOWS DR
OKLAHOMA CITY OK
73170-7542
US

IV. Provider business mailing address

15405 STONE MEADOWS DR
OKLAHOMA CITY OK
73170-7542
US

V. Phone/Fax

Practice location:
  • Phone: 405-205-8093
  • Fax:
Mailing address:
  • Phone: 405-205-8093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number226405
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: